Initiatives on Malaria ... (7)
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Source: <malaria@wehi.edu.au>
Clive Shiff wrote:
Recently I have had reports from colleagues in Bagamoyo that the re-
volving funds are still in place and that the village committees were
still interested in continuing the work...
Dear Clive,
I find a little difficult to share your views on how the Bagamoyo Proj-
ect (which is often cited as a successful example of treated net proj-
ect) is currently faring. I think one should be concerned with the fact
that two years after the researchers left the area - with all the
structures and money still available - nothing is moving. Supplies do
exist in Dar es Salaam and it is "only" a matter of going there (60 KM)
and getting the stuff. Even insecticide can be obtained at the Central
Medical stores.
My personal view is that such community committees are very useful to
go along projects - to help design and promote a new intervention - but
that they are not functional for actually implementing them. In the
case of insecticide-treated nets, which are commercial goods rather
than medical products, we should rely much more on the private sector.
A light infrastructure has then to be built up at national level to
keep the distribution moving. A useful model exists with condom social
marketing projects. Our own experience from the KINET project in Tanza-
nia is that this is a much more functional and efficient system.
I think we need to challenge the "PHC/community approach" for a number
of malaria interventions - without going back to heavy vertical pro-
grammes.
Regards,
Christian Lengeler
Swiss Tropical Institute
mailto:lengeler@ubaclu.unibas.ch
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